I.V. Vasilyeva - Dr. Sci. (Med.), Professor, Head of the Department of Medical Cybernetics and Informatics of Russian National Research Medical University named after N.I. PIROGOV, Moscow
S.L. Shvirev - Dr. Sci. (Med.), Professor, Head of the Department of Medical Cybernetics and Informatics of Russian National Research Medical University named after N.I. PIROGOV, Moscow
T.B. Zarubina - Dr. Sci. (Med.), Professor, Head of the Department of Medical Cybernetics and Informatics of Russian National Research Medical University named after N.I. PIROGOV, Moscow

Trauma is leading cause of death and significant cause of morbidity for children and adolescents of the last decennary. The modern medicine in children's traumatology is directed to prevention cause of trauma, timely rendering of medical care and objective assessment of weight of trauma for treatment of patients with trauma. In particular the objective estimation of weight of a trauma at treatment of patients is based on prognostic scores allow objective estimate the weight of damage of patients and objective estimate the weight of a condition of patients. So Prognostic scales ISS-RTS-TRISS (Boyd and colleagues in 19871,2), PRISM (Polllack M.M. et al., 19883), APACHE II (Knaus et al., 19854) widely are used for objective evaluation of weight of a condition of patients and probability of death outcome. Also Prognostic scale PTS (Tepas J.J. and colleagues, 19875) allow to sort patients by injury weight and to prescribe correct medical for trauma and to define tactics of medical care for patients. However the application of these scales in children of Russian population is not yet studied in sufficient. And question of application of these scales is open. The aim of the study was investigation of predictive validity of scales PRISM, APACHE II, ISS-RTS-TRISS and PTS in pediatric patients with trauma admitted to the Department of Anesthesiology Resuscitation. A retrospective study was conducted using the clinical and physiological data known at the time of admission and collected during the first 24 hours of hospitalization in 166 patients to Clinical and Research Institute of Urgent Pediatric Surgery and Trauma between January of 2008 and January of 2012. The median of age is nine years old. There were one hundred eleven (67%) males and fifty five females (33%), from them sixteen patients has died (9,6%). All admissions to the Department of Anesthesiology and Resuscitation calculated the probability of dying by prognostic scales PRISM, APACHE II, ISS-RTS-TRISS and the severity of injury was assessed using the scale of PTS. We investigated the calibration of prognostic scales using C-test of HosmerLemeshow test6 and discriminatory power of prognostic scales by constructing ROC-curve7. Results of calculations of C-criterion showed satisfactory ability to prognostic scales PRISM (χ2 = 9,3 and p = 0,23), APACHE II (χ2 = 7,28 and p = 0,507), ISS-RTS-TRISS (χ2 = 10.96 and p = 0.204). Results of ROC-analysis for prognostic scales PRISM, APACHE II and severity scale of the injury PTS showed acceptable discriminatory power (AUROC = 0.760 for PRISM; AUROC = 0,790 for APACHE II; AUROC = 0.781 for PTS). Result for prognostic score ISS-RTS-TRISS showed excellent discrimination ability (AUROC = 0.844).

 

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